Tuesday, 19 March 2013

Merger Mania five.


One of the findings of the report came out of their study into the effects of competition on the provision of State Health services; this is the creating of an artificial ‘market’, where none really exists.

So in the NHS, the State buys all the services for the patients. Once upon a time there was a great big plan, attempting to match need against resources. It didn’t always work out – that’s the thing with fallible human beings and plans – but they were trying.

Now plans are out and the ‘free’ market is in.

All recent governments have tried to create some kind of market in the belief that ‘competition’ would be more efficient than planning for health needs (that is putting services just where they are needed).

The thing is, a free market is a pretty unfeeling thing, at least where healthcare provision is concerned.

I quote from the report;


“Third, we contribute to research on whether planned systems in welfare provision achieve better outcomes than the private market. There has been a great deal of interest in recent years in competition in education, both theoretically and empirically (e.g., Epple and Romano 1998; Hoxby 2000; Epple, Figlio, and Romano 2004). Initial positive findings on the impact of competition in education (e.g. Hoxby 2000) gave impetus to attempts to promote competition. These findings, however, have been challenged by later research which suggests that the benefits from competition are less easy to achieve (e.g. Rothstein 2007; Bayer and McMillan 2005). Our findings suggest that, in the case of UK hospitals, configuration of the market by government does not result in the promised gains either.”


It looks that trying to create a market where there isn’t a market, doesn’t work. Not least because merging hospitals means reducing competition . That goes back to the ‘median hospital market’ – which is about how many choices you actually get in the real world – which actually fell from 7 to 5, after the mergers. There are some other studies on this and (yawn) I’ll be taking a look at them in the weeks to come.

Foundation Hospitals and G.P.’s commissioning groups are the latest attempt to create a ‘market’ where it doesn’t exist, it’s all about to start next month and it’s going to be run by Sir David Nicholson (Mid-staffs hospital).

That’s not so good.

Meanwhile, there are three more chunks of this – I never said it would be easy.



Neil Harris

(a don’t stop till you drop production)
Home:     helpmesortoutstpeters.blogspot.com
Contact:  neilwithpromisestokeep@gmail.com

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